■血液生物标志物在危重病人的诊断和治疗中起着核心作用,然而,在院外心脏停搏(OHCA)的停搏期间,均未进行常规测量.我们的目标是描述方法论方面,证据来源,以及围绕OHCA停滞内血液生物标志物的研究空白。
■我们使用范围审查方法来总结现有文献。该协议是根据用于系统审查和荟萃分析的首选报告项目(PRISMA)扩展进行的先验设计的。纳入标准是对至少一次抽血停滞的OHCA患者进行同行评审的科学研究。我们排除了院内心脏骤停和动物研究。没有语言,date,或研究设计排除。我们使用PubMed和Embase进行了电子文献检索,并手工检索了次要文献。使用标准化数据提取模板一式两份地进行数据图表/合成。
■搜索策略确定了11,834条记录,118项研究评估了105项血液生物标志物。只有8项研究(7%)有完整的报告。每个生物标志物的研究中位数为2(四分位间距1-4)。大多数研究在亚洲进行(63项研究,53%)。只有22项研究(19%)在院前环境中收集了血液样本,只有6项研究(5%)由护理人员收集样本。儿科患者仅被纳入三项研究(3%)。在八个预定义的生物标志物类别中,只有两项常规评估:预后性(97/105,92%)和诊断性(61/105,58%).
■尽管有大量关于OHCA停滞内血液生物标志物的文献,方法和知识方面的差距是普遍存在的。
UNASSIGNED: Blood-based biomarkers play a central role in the diagnosis and treatment of critically ill patients, yet none are routinely measured during the intra-arrest phase of out-of-hospital cardiac arrest (OHCA). Our objective was to describe methodological aspects, sources of evidence, and gaps in research surrounding intra-arrest blood-based biomarkers for OHCA.
UNASSIGNED: We used scoping
review methodology to summarize existing literature. The protocol was designed a priori following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. Inclusion criteria were peer-reviewed scientific studies on OHCA patients with at least one blood draw intra-arrest. We excluded in-hospital cardiac arrest and animal studies. There were no language, date, or study design exclusions. We conducted an electronic literature search using PubMed and Embase and hand-searched secondary literature. Data charting/synthesis were performed in duplicate using standardized data extraction templates.
UNASSIGNED: The search strategy identified 11,834 records, with 118 studies evaluating 105 blood-based biomarkers included. Only eight studies (7%) had complete reporting. The median number of studies per biomarker was 2 (interquartile range 1-4). Most studies were conducted in Asia (63 studies, 53%). Only 22 studies (19%) had blood samples collected in the prehospital setting, and only six studies (5%) had samples collected by paramedics. Pediatric patients were included in only three studies (3%). Out of eight predefined biomarker categories of use, only two were routinely assessed: prognostic (97/105, 92%) and diagnostic (61/105, 58%).
UNASSIGNED: Despite a large body of literature on intra-arrest blood-based biomarkers for OHCA, gaps in methodology and knowledge are widespread.